At Community First Health Plans, it is not a condition of employment or part of the evaluation process to base performance ratings, allow compensation or financial incentives for:
Utilization Management decision-making is based only on appropriateness of care, service, and existence of coverage.
Members who have questions or who are in need of assistance regarding the Utilization Management process may call Community First Health Plans at:
|Medicaid Members:||(210) 358-6060||1-800-434-2347|
|CHIP Members:||(210) 358-6300||1-800-434-2347|
|Commercial Members:||(210) 358-6070||1-800-434-2347|
|ERS Members:||(210) 358-6262||1-877-698-7032|
|University Family Care Plan Members:||(210) 358-6090||1-800-434-2347|
Providers with questions regarding the Utilization Management Process, or who wish to obtain a copy of the criteria used in the decision making process, may call the Health Services Management Resolution Unit at (210) 358-6050.